[rayiner]

Those are two odd examples. The Affordable Care Act is similar to the Netherlands health insurance system: https://www.commonwealthfund.org/blog/2011/lessons-abroad-du... (“These similarities are not entirely coincidental. American public officials, health industry leaders, and scholars made frequent visits to the Netherlands in the run-up to the debate over U.S. health care reform, borrowing ideas and, on occasion, citing the Dutch system as a model for what the U.S. might achieve.”).

As to rail, both the first-gen and second-gen Acela is based on the French TGV.

[redczar]

The U.S. has a pitiful amount of high speed rail. It serves no point to mention that this pitiful amount of high speed rail is based off of TGV.

The comparison to the Dutch healthcare system is not apt. While the Heritage foundation may used ideas from the Dutch system our system is quite a bit more Byzantine and inefficient. We spend twice as much per capita on healthcare and have worse outcomes and fewer people covered. Our citizens have far more per capita medical debt than the Dutch.

We didn’t really implement the Dutch system and we didn’t really learn from the French how to build and maintain high speed rail. Saying we learned healthcare from the Dutch because we have doctors like they do makes as much sense as your argument.

[0xDEAFBEAD]

The original claim was "The US rarely looks into how other countries solve problems". That claim appears to be false.

Why does the US execution not match that of the countries it looks into? I think it's because talented people in the US disproportionately go into the private sector, leading to an incompetent public sector. American distrust of their government is arguably justified.

[seper8]

You're also twice as fat so I think spending twice makes perfect sense

[Aeolun]

> The Affordable Care Act is similar to the Netherlands health insurance systemh

> The average Obamacare plan costs $483 monthly for a 30-year-old, $544 for a 40-year-old and $760 for a 50-year-old.

> The bronze plan covers 60% of the costs associated with care.

I feel like they missed the most important parts of the Dutch health insurance system…

[rayiner]

The Dutch system also requires payment of monthly premiums. The US premiums reflect the cost to insure the US’s significantly less healthy population.

[Aeolun]

I very much doubt that is true. Medical care is much cheaper when you don’t have to wait until it’s life threatening to get it.

[seanmcdirmid]

I thought the ACA was based on the Swiss system of mandatory insurance? The heritage foundation copied the Swiss, Romney took that proposal to Mass, and Obama thought going with a Conservative initiated plan would make it more bipartisan (it didn’t, but mainly because republicans hated Obama).

[tomp]

Definitely not.

IMO the most distinct parts of the Swiss health insurance system is that (1) copay is obligatory but limited (i.e. healthcare isn’t free but it’s not expensive either), and (2) it’s individual, companies cannot pay for it, so there’s no US-like extreme benefit of having a good job.

[rahkiin]

In the Netherlands we have those two as well, but it is also regulated: - the cheapest plan must not cost more than 115 eur (dont know exactly), and it has mandatory coverage (‘basisverzekering’) - there is a maximum copay of 850eur per year (‘eigen risico’) - some services are not allowed to have copay - low income people can have extra subsidies to pay for insurance - insurance is mandatory - insurance is a personal thing, not a work-thing. Your work absollutely knows nothing about your health insurance

Due to the regulations it is not a big run to the bottom

[seanmcdirmid]

Yes, having lived in Switzerland I experienced that, and it was the personal buy rather than having group plans was the feature missing from the ACA the most.

[waveBidder]

aca di. implement a market, it's just that most people buy through their job, because if that's legal you obviously want to be part of a larger bargaining pool for buying.

[seanmcdirmid]

Group plans suck away cream of crop risk pools. People with good stable high paying jobs tend to be a lot healthier than people working part time crap jobs or working in the trades for themselves.

It isn’t really bargaining power of the pool, but the risk assessment of the pool you are in. Being in a hodge lodge personal pool means you are sharing risk with people who will have more expenses. That’s why Switzerland throws everyone into the same pool, so no crème low risk can be siphoned away.